These council reports have proposed strategies to address health insurer actions that interfere with the patient/physician relationship and impact the practice of medicine. Such topics include prior authorization, covered benefits, and affordability of health insurance.
2025
- Requiring Payment for Physician Signatures (PDF) CMS Report 4-A-25
- Minimum Requirements for Medication Formularies CMS Report 9-A-25
2024
- Sustainable Payment for Community Practices (PDF) CMS Report 8-A-24
2023
- Health Insurers and Collection of Co-pays and Deductibles (PDF) CMS Report 2-I-23
- Strengthening Network Adequacy (PDF) CMS Report 3-I-23
- Medicare Coverage of Dental, Vision and Hearing (PDF) CMS Report 02-A-23
- Private Insurer Payment Integrity (PDF) CMS Report 03-A-23
- Health Care Marketplace Plan Selection (PDF) CMS Report 06-A-23
- Reporting Multiple Services Performed During a Single Patient Encounter (PDF) CMS Report 07-A-23
2021
- Reducing Inequities and Improving Access to Insurance for Maternal Health Care (PDF) CMS-CSAPH joint report N-21
- Access to Health Plan Information regarding Lower-Cost Prescription Options (PDF) CMS Report 2-N-21
- Covering the Remaining Uninsured (PDF) CMS Report 3-N-21
- Financing of Home and Community-Based Services (PDF) CMS Report 4-N-21
- Promoting Accountability in Prior Authorization (PDF) CMS Report 04-JUN-21
2020
- Options to Maximize Coverage Under the AMA Proposal for Reform (PDF) CMS Report 1-November 2020
- Mitigating the Negative Effects of High-Deductible Health Plans (PDF) CMS Report 2-November 2020. Read the issue brief for this report: Mitigating Negative Impacts of High-Deductible Health Plans (PDF).
- Health Plan Initiatives Addressing Social Determinants of Health (PDF) CMS Report 7-November 2020
2019
- Addressing Financial Incentives to Shop for Lower-Cost Health Care (PDF) CMS report 2-I-19
- Established Patient Relationships and Telemedicine (PDF) CMS report 1-I-19
- Health Plan Payment of Patient Cost-Sharing (PDF) CMS report 9-A-19
2018
- Aligning Clinical and Financial Incentives for High-Value Care (PDF) CMS/CSAPH joint report I-18. Read the issue briefs for this report: Promoting Access to High-Value Care (PDF) and Value-Based Insurance Design (PDF).
- Air Ambulance Regulations and Payments (PDF) CMS report 2-I-18
- Coverage for Colorectal Cancer Screening (PDF) CMS/CSAPH joint report A-18
- Improving Affordability In the Health Insurance Exchanges (PDF) CMS report 2-A-18. Read the issue briefs for this report: Improving Health Insurance Affordability (PDF), Taking Steps forward to Cover the Uninsured (PDF), and Using Reinsurance to Stabilize and Strengthen the Individual Market (PDF).
- Ensuring Marketplace Competition and Health Plan Choice (PDF) CMS report 3-A-18. Read the issue briefs for this report: Improving Health Insurance Affordability (PDF) and Taking Steps forward to Cover the Uninsured (PDF).
- Health Plans’ Medical Advice (PDF) CMS report 4-A-18
- Financing of Long-Term Services and Supports (PDF) CMS report 5-A-18. Read the issue brief for this report: Financing of Long-Term Services and Supports (PDF).
- Insulin Affordability (PDF) CMS report 7-A-18
2017
- Ensuring Continuity of Care Protections During Active Courses of Treatment (PDF) CMS report 3-A-17
- Expansion of U.S. Veterans’ Health Care Choices (PDF) CMS report 6-A-17
- Health Care Financing Models (PDF) CMS report 2-A-17
- Prior Authorization and Utilization Management Reform (PDF) CMS report 8-A-17
- Retail Health Clinics (PDF) CMS report 7-A-17
- Value of Preventive Services (PDF) CMS/CSAPH joint report A-17. Read the issue briefs for this report: Promoting Access to High-Value Care (PDF) and Value-Based Insurance Design (PDF).
- Affordable Care Act Section 1332 Waivers (PDF) CMS report 1-I-17. Read the issue briefs for this report: Improving Health Insurance Affordability (PDF) and Taking Steps forward to Cover the Uninsured (PDF).
- Health Insurance Affordability: Essential Health Benefits and Subsidizing the Coverage of High-Risk Patients (PDF) CMS report 4-I-17. Read the issue briefs for this report: Improving Health Insurance Affordability (PDF), Taking Steps forward to Cover the Uninsured (PDF), and Using Reinsurance to Stabilize and Strengthen the Individual Market (PDF).
2016
- Affordable Care Act Medicaid Expansion (PDF) CMS report 2-A-16. Read the issue brief for this report: Taking Steps forward to Cover the Uninsured (PDF).
- Access to Self-Administered Medications (PDF) CMS report 4-A-16
- Prior Authorization Simplification and Standardization (PDF) CMS report 7-A-16
- Infertility Benefits for Veterans (PDF) CMS report 1-I-16
2015
- Price Transparency (PDF) CMS report 4-A-15. Read the issue brief for this report: Price Transparency (PDF).
- Integrating Physical and Behavioral Health Care (PDF) CMS report 6-A-15
- Coverage for Chronic Pain Management (PDF) CMS/CSAPH joint report -A-15
- Hearing Aid Coverage (PDF) CMS report 6-I-15
- Health Insurance Affordability (PDF) CMS report 8-I-15. Read the issue briefs for this report: Improving Health Insurance Affordability (PDF) and Taking Steps forward to Cover the Uninsured (PDF).
2014
- Health Insurer Code of Conduct Principles (PDF) CMS report 5-A-14
- Improving the Affordable Care Act (PDF) CMS report 9-A-14
- Privacy Issues Regarding Insurance Company Explanation of Benefits (PDF) CMS report 2-I-14
- Reference Pricing (PDF) CMS report 3-I-14
- Network Adequacy (PDF) CMS report 4-I-14
- The Future of Employer-Sponsored Insurance (PDF) CMS report 6-I-14
- Modernizing TRICARE Payment Policies (PDF) CMS report 8-I-14
2013
- Worksite Health Clinics (PDF) CMS report 1-A-13
- Value-Based Insurance Design (PDF) CMS report 2-A-13. Read the issue briefs for this report: Promoting Access to High-Value Care (PDF) and Value-Based Insurance Design (PDF).
- Medical Record and reporting Standardization Update (PDF) CMS report 2-I-13
- Monitoring the Affordable Care Act (PDF) CMS report 5-I-13
2012
- Basic Health Program (PDF) CMS report 5-A-12
- Small Businesses and Health Reform (PDF) CMS report 6-A-12
2011
- Essential Health Care Benefits (PDF) CMS report 2-A-11
- Covering the Uninsured and Individual Responsibility (PDF) CMS report 9-A-11
- Administrative Simplification In the Physician Practice (PDF) CMS report 8-I-11
2009
- Radiology Benefits Managers (PDF) CMS report 5-I-09
2008
- Medical Care Outside the United States (PDF) CMS report 1-A-08
- The Role of Cash Payments in All Physician Practices (PDF) CMS report 3-A-08
- Value-Based Decision-Making in the Health Care System (PDF) CMS report 7-A-08
- Acceptance of TRICARE Health Insurance (PDF) CMS report 2-I-08
2007
- Adequacy of Health Insurance Coverage Options (PDF) CMS report 7-A-07
- Cost-Sharing Arrangements for Prescription Drugs (PDF) CMS report 1-I-07
Additional information
Access all council reports prior to 2007 or learn more about the Council on Medical Service.
